Sak Sibel, Barut Mert, Incebiyik Adnan, Ağaçayak Elif, Kirmit Adnan, Koyuncu Ismail, Sak Muhammet
a Department of Obstetrics and Gynecology , Harran University School of Medicine , Sanliurfa , Turkey.
b Department of Obstetrics and Gynecology, School of Medicine , Dicle University , Diyarbakir , Turkey.
J Matern Fetal Neonatal Med. 2019 Mar;32(6):910-915. doi: 10.1080/14767058.2017.1395016. Epub 2017 Nov 2.
The study aims to evaluate the maternal serum and the vaginal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecular (sICAM-1) in pregnant women complicated by preterm prelabour ruptures of membranes (PPROM).
The prospective case control study included 34 pregnant women with PPROM and 34 healthy pregnant women. Patients with additional diseases, a smoking habit and vaginal bleeding, as well as those using antibiotics, during the study period were not included in the study. Cervicovaginal fluid and serum samples were taken during the patients' admission. The demographic data, maternal serum and vaginal fluid sVCAM-1 and sICAM-1, C reactive protein (CRP) and leukocyte counts were noted for all pregnant women included in the study. The sVCAM-1 and sICAM-1 levels were measured by enzyme-linked immunosorbent assay kits.
In pregnant women with PPROM, the serum leukocyte (mean ± SD =11.41 ± 1.067 versus 9.18 ± 1.56, p < .0001), serum sVCAM-1 (median 771.20 versus 704.60 ng/ml, p < .001), sICAM-1 (mean ± SD 213.10 ± 35.59 ng/ml versus 188.11 ± 37.35 ng/ml, p = .06), vaginal sVCAM-1 (median 208.00 versus 140.20 ng/ml, p = .014) and sICAM-1 (mean ± SD 32.32 ± 6.49 ng/ml versus 24.87 ± 6.79 ng/ml, p < .001) values were found to be significantly higher in pregnant women with PPROM than in healthy pregnant women. A positive and significant correlation was observed between the leukocyte count and the vaginal sVCAM-1 level (r = 0.850; p < .001).
To the best of our knowledge, this is the first study evaluating the levels of sICAM-1 in maternal serum in pregnant women with PPROM. The maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels can be used as biochemical markers supporting the PPROM diagnosis because of the increase in both maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels in pregnant women with PPROM.
本研究旨在评估合并胎膜早破（PPROM）的孕妇血清及阴道液中可溶性血管细胞黏附分子-1（sVCAM-1）和可溶性细胞间黏附分子（sICAM-1）的水平。
这项前瞻性病例对照研究纳入了34例PPROM孕妇和34例健康孕妇。研究期间患有其他疾病、有吸烟习惯、有阴道出血以及使用抗生素的患者未纳入本研究。在患者入院时采集宫颈阴道液和血清样本。记录纳入研究的所有孕妇的人口统计学数据、母体血清和阴道液中的sVCAM-1、sICAM-1、C反应蛋白（CRP）和白细胞计数。sVCAM-1和sICAM-1水平采用酶联免疫吸附测定试剂盒进行检测。
PPROM孕妇的血清白细胞（平均值±标准差=11.41±1.067对9.18±1.56，p<0.0001）、血清sVCAM-1（中位数771.20对704.60 ng/ml，p<0.001）、sICAM-1（平均值±标准差213.10±35.59 ng/ml对188.11±37.35 ng/ml，p=0.06）、阴道sVCAM-1（中位数208.00对140.20 ng/ml，p=0.014）和sICAM-1（平均值±标准差32.32±6.49 ng/ml对24.87±6.79 ng/ml，p<0.001）值均显著高于健康孕妇。白细胞计数与阴道sVCAM-1水平之间存在显著正相关（r=0.850；p<0.001）。
据我们所知，这是第一项评估PPROM孕妇母体血清中sICAM-1水平的研究。由于PPROM孕妇母体血清和阴道液中sVCAM-1和sICAM-1水平均升高，母体血清和阴道液中的sVCAM-1和sICAM-1水平可作为支持PPROM诊断的生化标志物。
